Cited by 487Hair Growth and DisordersPluripotent Stem Cells ResearchSkin and Cellular Biology Research

The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index; 44 of the 56 sources its claims cite were checked for support.

Hair-bearing human skin generated entirely from pluripotent stem cells

Open access

Published version of a preprint

Abstract

The skin is a multilayered organ, equipped with appendages (that is, follicles and glands), that is critical for regulating body temperature and the retention of bodily fluids, guarding against external stresses and mediating the sensation of touch and pain 1,2. Reconstructing appendage-bearing skin in cultures and in bioengineered grafts is a biomedical challenge that has yet to be met 3-9. Here we report an organoid culture system that generates complex skin from human pluripotent stem cells. We use stepwise modulation of the transforming growth factor β (TGFβ) and fibroblast growth factor (FGF) signalling pathways to co-induce cranial epithelial cells and neural crest cells within a spherical cell aggregate. During an incubation period of 4-5 months, we observe the emergence of a cyst-like skin organoid composed of stratified epidermis, fat-rich dermis and pigmented hair follicles that are equipped with sebaceous glands. A network of sensory neurons and Schwann cells form nerve-like bundles that target Merkel cells in organoid hair follicles, mimicking the neural circuitry associated with human touch. Single-cell RNA sequencing and direct comparison to fetal specimens suggest that the skin organoids are equivalent to the facial skin of human fetuses in the second trimester of development. Moreover, we show that skin organoids form planar hair-bearing skin when grafted onto nude mice. Together, our results demonstrate that nearly complete skin can self-assemble in vitro and be used to reconstitute skin in vivo. We anticipate that our skin organoids will provide a foundation for future studies of human skin development, disease modelling and reconstructive surgery.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

A stepwise human pluripotent stem cell organoid culture using TGFβ/FGF pathway modulation self-assembles hair-bearing skin with stratified epidermis, fat-rich dermis, pigmented hair follicles, sebaceous glands, sensory neurons, and Merkel cells. Single-cell RNA-sequencing and foetal comparison suggest second-trimester facial skin identity, and grafted organoids form planar hair-bearing skin on nude mice.

Key findings

  • Hair germs appeared at 70 ± 5 days for WA25 and 72 ± 4 days for DSP-GFP organoids; hair follicle production occurred in 87.4% of WA25, 87.2% of DSP-GFP, and 70.8% of WA01 organoids. Pigmented hair-bearing organoids formed in 53.5% of WA25 and 76.2% of DSP-GFP cultures (p=0.077).
  • scRNA-seq identified 23,329 cells at day-6 and 18,190 cells at day-29; day-6 populations were epithelial ~59%, neuro-glial ~8%, mesenchymal ~8%, and cycling ~25%, while day-29 was dominated by mesenchymal cells ~70%, with epithelial ~17%, neuro-glial ~7%, and cycling ~6%.
  • Organoids showed craniofacial identity, including first pharyngeal arch markers and lack of HOX gene expression, and were proposed as equivalent to human facial skin in the second trimester.
  • In xenografts, 55% of grafts (15 of 27, 3 experiments) grew 2–5 mm hairs, 22% had in-grown hairs, and 22% failed; no grafts showed ulceration or uncontrolled tumour-like growth.

Methods

  • hPSCs (WA25 hESC, DSP-GFP hiPSC, and WA01 validation) were aggregated at 3,500 cells per U-bottom well, differentiated with Matrigel, SB431542, FGF, and BMP-4, then LDN/FGF at day-3; organoids were matured in floating culture on an orbital shaker for up to ~150 days.
  • scRNA-seq used 10x Genomics Chromium, CellRanger, and Seurat; day-6 organoids (n=10) and day-29 organoids (n=5) were pooled, and day-48 WA25 organoids (n=6) had tail structures removed before dissociation.
  • Xenografts used day 113–145 hair-bearing WA25 organoids with tails removed, implanted into 1–2 mm incisions in back skin of 5–6-week-old female nude mice, then analysed by histology, immunostaining, and electron microscopy.

Limitations

  • The paper states that sweat glands were absent, that additional molecular and physiological profiling is needed to determine whether other somatosensory neuron subtypes and nerve endings can be induced, and that long-term (>1 year) observation is needed to determine terminal hair fate or growth cycling.
  • The paper notes that off-target cell lineages require additional control before clinical reconstitution, and that cell-line variability suggests further protocol optimization may be needed.
  • The text also makes evident that no statistical test was used to predetermine sample size, investigators were not blinded to treatment groups, and experiments were generally not randomized; xenograft failures and in-grown hairs were attributed partly to technical issues.

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Integrity signals

Registry

Crossref · 10.1038/s41586-020-2352-3

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

53 Own result · 17 Partly supported · 13 Own interpretation · 11 Own method · 7 No full text of the sources · 5 Couldn’t confirm · 2 Supported · 1 Supported so far · 1 Not supported · 1 No basis given · accuracy not yet measured

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  • Probably not a substantial claim. 15
  • It may state two separate claims as one. 26
  • The quote only partly states this claim. 2
38 of 38
  • The authors state this as an assumption.

    The site of axon targeting in organoid HFs is the bulge region.

    “which we presume to be the bulge region of the HFs”
1 of 1

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Metadata

Authors
Lee, J., Rabbani, C. C., Gao, H., Steinhart, M. R., Woodruff, B. M., Pflum, Z. E., Kim, A., Heller, S., Liu, Y., Shipchandler, T. Z., & Koehler, K. R.
Affiliations
  • Boston Children's Hospital (US)
  • Johns Hopkins University (US)
  • Indiana University School of Medicine
  • Stanford Medicine (US)
Corresponding author
Koehler, Karl R.
Venue
Nature
Published
2020-06-03
Volume
582
Issue
7812
Pages
399-404
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W3032142305
Cited by
487
References
44
Citations by year
2026: 82 · 2025: 85 · 2024: 85 · 2023: 75 · 2022: 80 · 2021: 68 · 2020: 12
FWCI
58.89
Type
journal article
Language
en
Open access
Locations
  • Nature (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion)
  • IUScholarWorks (Indiana University) (submittedVersion)
Funders
  • Indiana Clinical and Translational Sciences Institute (UL1TR001108, RR020128, TR001108)
  • University of Washington (5R24HD000836)
  • National Institutes of Health (1c06rr020128-01, 5R24 HD000836, UL-1-TR001108, TR001108, R01DC017461, R03DC015624, R01AR075018)
  • National Institute on Deafness and Other Communication Disorders (R01 DC017461, R03DC015624)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR075018)
  • National Institute of Child Health and Human Development
  • National Center for Research Resources (C06-RR020128)
  • National Center for Advancing Translational Sciences (UL1TR-001108)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24 HD000836, 5R24HD000836)
Topics
  • Health Sciences › Medicine › Dermatology › Hair Growth and Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Pluripotent Stem Cells Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Skin and Cellular Biology Research
Keywords
skin organoids, pluripotent stem cells, hair follicle, sebaceous glands, TGF-beta signaling, FGF signaling, neural crest cells, Merkel cells, sensory neurons, Schwann cells, epidermis, dermis, skin grafting, skin development, disease modeling, reconstructive surgery
MeSH terms
RNA-Seq, Animals, Ectoderm, Female, Hair, Hair Color, Head, Humans, Mice, Nude, Organoids, Skin, Skin Transplantation, Hair Follicle, Pluripotent Stem Cells, Mice, Single-Cell Analysis, Heterografts

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